Impact of different COVID-19 waves on kidney replacement therapy epidemiology and mortality: REMER 2020

Autor: Sol, Carriazo, Manuel I, Aparicio-Madre, Fernando, Tornero-Molina, Milagros, Fernández-Lucas, Vicente, Paraiso-Cuevas, Emilio, González-Parra, Francisco, Del Río-Gallegos, María, Marques-Vidas, Roberto, Alcázar-Arroyo, Judith, Martins-Muñoz, Rafael, Sánchez-Villanueva, Beatriz, Gil-Casares, Eduardo, Gutiérrez-Martínez, María Pilar, Martínez-Rubio, Alberto, Ortiz, Marta Sanz, Sainz
Rok vydání: 2022
Předmět:
Zdroj: Nephrology Dialysis Transplantation. 37:2253-2263
ISSN: 1460-2385
0931-0509
DOI: 10.1093/ndt/gfac234
Popis: Background Kidney replacement therapy (KRT) confers the highest risk of death from coronavirus disease 2019 (COVID-19). However, most data refer to the early pandemic waves. Whole-year analysis compared with prior secular trends are scarce. Methods We present the 2020 REMER Madrid KRT registry, corresponding to the Spanish Region hardest hit by COVID-19. Results In 2020, KRT incidence decreased 12% versus 2019, while KRT prevalence decreased by 1.75% for the first time since records began and the number of kidney transplants (KTs) decreased by 16%. Mortality on KRT was 10.2% (34% higher than the mean for 2008–2019). The 2019–2020 increase in mortality was larger for KTs (+68%) than for haemodialysis (+24%) or peritoneal dialysis (+38%). The most common cause of death was infection [n = 419 (48% of deaths)], followed by cardiovascular [n = 200 (23%)]. Deaths from infection increased by 167% year over year and accounted for 95% of excess deaths in 2020 over 2019. COVID-19 was the most common cause of death (68% of infection deaths, 33% of total deaths). The bulk of COVID-19 deaths [209/285 (73%)] occurred during the first COVID-19 wave, which roughly accounted for the increased mortality in 2020. Being a KT recipient was an independent risk factor for COVID-19 death. Conclusions COVID-19 negatively impacted the incidence and prevalence of KRT, but the increase in KRT deaths was localized to the first wave of the pandemic. The increased annual mortality argues against COVID-19 accelerating the death of patients with short life expectancy and the temporal pattern of COVID-19 mortality suggests that appropriate healthcare may improve outcomes.
Databáze: OpenAIRE
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